M2型巨噬细胞标志物CD163与结直肠癌预后的关系

目的：以CD163蛋白为标志物探讨人结直肠癌组织中M2型巨噬细胞与患者预后的关系。方法：收集海军军医大学附属长海医院肛肠外科于2010年1月至2011年12月期间接受外科手术的648例初治结直肠癌患者的临床资料及其术后肿瘤组织石蜡标本，患者诊断均经术后病理证实。对照组分别为：上述标本中38例患者的癌旁组织，37例痔上黏膜环切钉合术(PPH)术后正常直肠黏膜组织和33例内镜治疗后的结直肠腺瘤组织。所有组织标本制作成组织芯片，免疫组化检测CD163蛋白表达水平，分析不同表达水平与结直肠癌临床病理参数和预后的关系。结果：CD163的表达水平与肿瘤分化程度、血清CA19-9、肿瘤复发转移有关（均P＜0.05）。生存分析发现CD163高表达组较低表达组无病生存率和总生存率低、预后差（P<0.001）。Cox多因素分析显示，血清CEA、CD163表达水平也是结直肠癌预后的独立影响因素（均P＜0.05）。结论：M2型巨噬细胞标志物CD163对于结直肠癌患者的预后有较好的参考价值。

Relationship between M2 macrophages marker CD163 and prognosis of colorectal cancer

Objective To investigate the relationship between M2 macrophages and prognosis of patients with human colorectal cancer by using CD163 protein as a marker. Methods The clinical data and paraffin samples of 648 patients with newly diagnosed colorectal cancer and the paraffin specimens of the tumor tissues after operation were collected from Jan. 2010 to Dec. 2011 in the Department of Colorectal Surgery, Changhai Hospital, Navy Medical University (Second Military Medical University). All patients were diagnosed by postoperative pathology. Paracancerous tissues of the above 38 patients, normal colorectal mucosal tissues of 37 patients undergoing hemorrhoidectomy (PPH), and colorectal adenoma tissues of 33 patients receiving endoscopic treatment served as controls. All specimens were made into tissue microarrays, and the expression of CD163 protein was detected by immunohistochemistry. The relationships between the expression of CD163 protein and clinicopathological parameters and prognosis of patients with colorectal cancer were analyzed. Results The expression level of CD163 was related to the degree of tumor differentiation, serum carbohydrate antigen 19-9 (CA19-9) and tumor recurrence and metastasis (all P<0.05). Survival analysis showed that the high CD163 expression group had lower disease-free survival and overall survival rates and poor prognosis compared with the low CD163 expression group (P<0.001). Cox multivariate analysis showed that serum expression levels of carcinoembryonic antigen (CEA) and CD163 were independent prognosis factors of patients with colorectal cancer (P<0.05). Conclusion M2 macrophage marker CD163 has a good reference value for the prognosis of patients with colorectal cancer.